John Leverenz, Neurological Surgery

Going to Bat for JD

Seventeen years ago, Christine Leverenz gave birth at Northwest Hospital, but this is not her story. In 2007, John Leverenz had surgery on his back at Northwest Hospital. This is not John's story either. It is their son, JD's story.

John Dane seems a suitable name for the 17-year-old Ballard High-schooler who is as big as a Great Dane and takes up as much space in the small living room of the family's Seattle home. The avid baseball player sports a worn Ballard Beavers Baseball t-shirt.

"I'm a catcher," JD says. "Actually, the catcher is one of the most challenging positions in baseball because you have to control the flow of the game, keep your pitcher cool and know what the batter is going to do."

JD is no stranger to challenge. On the Thursday before Halloween in 2009, he was sitting on the couch in front of the TV when he had a seizure. His mother Christine, 50, says his eyes went blank and he became unresponsive. She knew immediately that something was wrong.

"I asked him what we had that evening for dinner and he couldn't answer me," she says.
"I could think of what we had to eat, but I couldn't say it," JD chimes in. "I was worried, but I thought she was overreacting. I didn't want to go to the hospital."

What followed was a 36-hour stay in Northwest Hospital's emergency room. JD underwent a series of tests including blood work, a chest X-ray, an MRI, and a CT-scan. While JD maintained his cool baseball catcher-calm on the outside, he replayed a worst-case scenario in his mind.

"The first thing that pops into your head is 'what is going to happen to me'," he admits. "I thought 'I don't want to die. I want to have a full life and I have so many things I still want to do.' But deep down, I knew there was something wrong. I couldn't ignore that."

JD describes himself as a big brute of a kid. Aside from minor colds and infrequent ear infections, he has never been sick. When Northwest Hospital neurosurgeon Dr. Daniel Lazar showed JD images of his brain, JD says his life changed. A ganglioglioma, a grapefruit-sized tumor, was invading the left temporal lobe of his brain. The tumor was slow-growing and benign, but was so large that it had begun to interfere with normal, vital brain functions, causing JD's seizure.

"Given the size and location of the tumor, there was no other option than to operate," Dr. Lazar says. "The temporal lobe may be one of the most important parts of our brain with respect to our language, memory and ability to understand."

Dr. Lazar allowed JD to spend the weekend at home before his surgery. John, 54, and Christine made plans to keep their son busy and to maintain a sense of normalcy. They went shopping, ate pizza, took his cousin trick-or-treating, and visited the zoo. JD required constant monitoring in the case of another seizure. Christine took up a permanent vigil sleeping at the foot of her son's bed. She didn't sleep much and on the night before his surgery, neither did JD.

As JD's care team began prepping him for surgery, reality began to set in. JD grew more tense and anxious. John noticed the change and tried to calm his son.

"What if I'm never able to hold a bat or throw a ball again?" JD asked his dad.

"Don't worry, you'll play ball again," John said.

It was November 2. The Philadelphia Phillies were squared off against the New York Yankees in Game 5 of the World Series. JD wanted to watch the game, but instead he went through eight hours of surgery and took 33 staples in the head. The Phillies took the game eight to six.

As with any operation, brain surgery comes with certain risks. In JD's case, operating on the temporal lobe of the brain could cause problems with speech, memory, muscle weakness, balance, vision, coordination and other functions.

When JD woke up in Northwest Hospital's intensive-care unit his recovery began. Nurses managed his pain and frequently tested his neurological functions. A brain tumor and its treatment can cause changes in the way people think, act, see or feel, and a coordinated series of post-operative consults were necessary to make sure JD was recuperating properly. A physical therapist evaluated JD's muscle strength, coordination and balance. An occupational therapist assessed JD's ability to take care of his basic daily needs such as bathing, eating and getting dressed. Last, was speech therapy.

JD passed the first two assessments with flying colors and the family imagined speech would be much the same. JD was communicating clearly and had no perceptible changes in speech patterns or his ability to understand. But Northwest Hospital speech pathologist Kara Baringer noticed something out of the ordinary. JD struggled with processing information and formulating appropriate responses.

"After I would ask him a question or explain something, he had to think about it for a long time and then had trouble saying what he meant," Baringer says.

Acquired language disorders are common symptoms after brain surgery. Depending on the area of the brain that is affected, a patient may experience problems with memory, speech or understanding. Sometimes patients are able to write but not speak or vice versa. Some patients also substitute one word when they mean to use another.

"Some of JD's immediate language impairments resolved themselves quickly and on their own," Baringer explains "We tailored a program to help him re-acclimate to school," Baringer says.

JD's hospital stay was peppered with visits from the Ballard High School baseball team, cheerleaders, friends and family members. John and Christine were touched by the outpouring of support for their son. After his four-day recovery, JD went home. Shortly after, he began outpatient speech therapy through Northwest Hospital's Center for Medical Rehabilitation. In a few short visits with Baringer, JD was already improving. She also worked with John and Christine and JD's high school teachers, helping JD create strategies to compensate for his processing delays. One of these was arranging for the school to allow JD to return part-time.

"The biggest battle was that JD's mind would get so tired," Baringer recalls. "So we gradually worked him back up to a full day of class. He missed nearly two months of school and he was still able to pass that semester of his junior year. That's amazing."

Today, school is easier for JD. He went from getting low-Cs and Ds, to high-Bs and As. Most of his post-operative challenges have subsided and he continues to use the skills Baringer taught him. Christine and John are visibly proud.

"He had to grow up pretty fast, and now he has a lot to look forward to," Christine says.

JDs parents appear as grateful to the hospital as they were on the day their son was born. It's difficult for Christine to talk about watching her only child have a seizure, spend a night in the ER, and undergo an emergency craniotomy.

"It's unbelievable. He's my only child. So hard. When I think of…" she manages before starting to cry.

"We knew we did the right thing in choosing Northwest Hospital. I think it's part of having had several surgeries there," John fills in for Christine. "And then partly Dr. Lazar. He has a way of talking to you that makes you feel so calm and confident."

With a 'whatever doesn't kill you makes you stronger' mentality, JD seems to live by the philosophy that life is best if you can find the humor in it all.

"I may have only half a brain but I am still smarter than most people," he jokes.
All joking aside, JD has changed. He works harder and smarter. He does his homework as soon as he arrives home, exercises to build back his muscle strength, trains for spring baseball and plans for the future. While he knows he is not as prepared physically to tackle the demands of a varsity baseball season, he is confident that by next year he will be back in top form.

In the end, through one of their most challenging experiences, this family discovered their most defining one. A brain tumor brought them closer and changed JD's outlook on life.

"You never know what's going to happen to you," he says. "You just have to continue to make the best of what you have, each day that you can."

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